The influence of pitch size on the efficacy of maturity status ‘bio-banding’ when using a multidisciplinary approach to identify talented adolescent soccer players

The present study aimed to evaluate the effect of relative pitch size on the tactical, technical, physical and psychological performance of youth academy soccer players, during maturity status ‘bio-banded’ small-sided game (SSG) match play, to evidence the consideration of player maturity status, during talent identification and (de)selection. Forty-four youth academy soccer players (age: 12.9 ± 0.9 years, weight: 46.4 ± 8.5 kg and stature: 158.2 ± 14.9 cm) were recruited from, two professional youth soccer academies. Players were allocated into one of four ‘bio-banded’ teams; two each of ‘post- PHV’ and ‘pre-PHV’ banded players, categorised based on percentage of adult stature attainment (EASA% > 90.0 and < 89.9, respectively) and competed against each other, within a ‘round-robin’ SSG’s format, across small (36 m2), medium (72 m2), large (109 m2) and expansive (145 m2) relative pitch sizes. Physical, Technical, Tactical and Psychological competence was measured throughout. Data were analysed using a linear mixed marginal-modelling with Sidak adjusted p values and effect sizes. Mismatched match play demonstrated an insignificant difference in movement demands between ‘post-PHV ‘ and ‘pre-PHV’ banded players (p = 0.06 to 0.94), however ‘pre-PHV’ banded players demonstrate a significant increase in physical loading and perception of physical experience (p = ≤ 0.001 to 0.03). Maturity matched SSG match play, demonstrated insignificant differences and equitable physical, technical/tactical, and psychological measures within maturity bandings (p = 0.07 to 0.98), whilst demonstrating a subsequent increase in apparent competence, in comparison to a maturity mismatched game constraint. Relative pitch size was found to be independent of maturity status. Such findings highlight the possible use of maturity status ‘bio-banded’ SSG match play within youth soccer academies for talent identification and (de)selection purposes by eliciting changes in physical, technical/tactical, and psychological response

Examination of differential ratings of perceived exertion (dRPE) during bio-banded small-sided games.

The aims of the current study were to investigate the use of dRPE with academy soccer players to: 1) examine the effect of bio-banded and non-bio-banded maturity groups within SSG on players dRPE; 2) describe the multivariate relationships between dRPE measures investigating the sources of intra and inter-individual variation, and the effects of maturation and bio-banding. Using 32 highly trained under (U) 12 to U14 soccer players (mean (SD) age 12.9 (0.9) years, body mass 46.4 (8.5) kg and stature 158.2 (14.9) cm) academy soccer players from two English professional male soccer academies. Players were categorised according to somatic maturity status using estimated percentage of adult stature attainment, with players randomly assigned into teams to play 4v4 SSG. The study used a repeated measures design, whereby the selected players participated within 6 bio-banded (maturity matched [pre-PHV Vs pre-PHV and post-PHV vs post PHV] and miss-matched [pre-PHV vs post-PHV] and 6 mixed maturity SSG at their respective clubs. Using mixed and fixed effect regression models, it was established hat pre-PHV players exhibited higher dRPE compared with their post-PHV counterparts. Mixed bio-banded games reported higher dRPE outputs overall. Variation in dRPE measures across a series of bio-banded games are caused by both between and within sources of variation in relatively equal amounts. Across a series of bio-banded games, the four dRPE measures do not provide unique information, and between variation is best expressed by one or two highly correlated components, with within variation best explained by a single equally loaded component. Using a bio-banding SSG design study, we have shown that pre-PHV players report higher subjective measures of exertion than post-PHV players during. Additionally, when evenly mixing players based on measures of maturation, higher measures of perceived exertion were generally reported

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Examination of differential ratings of perceived exertion (dRPE) during bio-banded small-sided games

The aims of the current study were to investigate the use of dRPE with academy soccer players to: 1) examine the effect of bio-banded and non-bio-banded maturity groups within SSG on players dRPE; 2) describe the multivariate relationships between dRPE measures investigating the sources of intra and inter-individual variation, and the effects of maturation and bio-banding. Using 32 highly trained under (U) 12 to U14 soccer players (mean (SD) age 12.9 (0.9) years, body mass 46.4 (8.5) kg and stature 158.2 (14.9) cm) academy soccer players from two English professional male soccer academies. Players were categorised according to somatic maturity status using estimated percentage of adult stature attainment, with players randomly assigned into teams to play 4v4 SSG. The study used a repeated measures design, whereby the selected players participated within 6 bio-banded (maturity matched [pre-PHV Vs pre-PHV and post-PHV vs post PHV] and miss-matched [pre-PHV vs post-PHV] and 6 mixed maturity SSG at their respective clubs. Using mixed and fixed effect regression models, it was established hat pre-PHV players exhibited higher dRPE compared with their post-PHV counterparts. Mixed bio-banded games reported higher dRPE outputs overall. Variation in dRPE measures across a series of bio-banded games are caused by both between and within sources of variation in relatively equal amounts. Across a series of bio-banded games, the four dRPE measures do not provide unique information, and between variation is best expressed by one or two highly correlated components, with within variation best explained by a single equally loaded component. Using a bio-banding SSG design study, we have shown that pre-PHV players report higher subjective measures of exertion than post-PHV players during. Additionally, when evenly mixing players based on measures of maturation, higher measures of perceived exertion were generally reported

The effect of bio-banding on academy soccer player passing networks: Implications of relative pitch size

The primary aims of this study were to examine the effects of bio-banding players on passing networks created during 4v4 small-sided games (SSGs), while also examining the interaction of pitch size using passing network analysis compared to a coach-based scoring system of player performance. Using a repeated measures design, 32 players from two English Championship soccer clubs contested mixed maturity and bio-banded SSGs. Each week, a different pitch size was used: Week 1) small (36.1 m2 per player); week 2) medium (72.0 m2 per player); week 3) large (108.8 m2 per player); and week 4) expansive (144.50 m2 per player). All players contested 12 maturity (mis)matched and 12 mixed maturity SSGs. Technical-tactical outcome measures were collected automatically using a foot-mounted device containing an inertial measurement unit (IMU) and the Game Technical Scoring Chart (GTSC) was used to subjectively quantify the technical performance of players. Passing data collected from the IMUs were used to construct passing networks. Mixed effect models were used with statistical inferences made using generalized likelihood ratio tests, accompanied by Cohen’s local f2 to quantify the effect magnitude of each independent variable (game type, pitch size and maturation). Consistent trends were identified with mean values for all passing network and coach-based scoring metrics indicating better performance and more effective collective behaviours for early compared with late maturation players. Network metrics established differences (f2 = 0.00 to 0.05) primarily for early maturation players indicating that they became more integral to passing and team dynamics when playing in a mixed-maturation team. However, coach-based scoring was unable to identify differences across bio-banding game types (f2 = 0.00 to 0.02). Pitch size had the largest effect on metrics captured at the team level (f2 = 0.24 to 0.27) with smaller pitch areas leading to increased technical actions. The results of this study suggest that the use of passing networks may provide additional insight into the effects of interventions such as bio-banding and that the number of early-maturing players should be considered when using mixed-maturity playing formats to help to minimize late-maturing players over-relying on their early-maturing counterparts during match-play